Provider Information for 1699131714
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KATHRYN DITTMANN LCPC
Sex: Female
NPI: 1699131714
Last Updated: 2022-04-26
Certification Date: 2022-04-12
Certification Date: 2022-04-12
Details
| Name | Value | ||||||||||||||||
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| NPI | 1699131714 | ||||||||||||||||
| Enumeration Date | 2016-01-05 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | NO | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | 67 EUSTIS PKWY WATERVILLE, ME 04901-5173 United States Phone: 207-660-4549 | Fax:207-660-4529 | ||||||||||||||||
| Primary Practice Address | 67 EUSTIS PKWY WATERVILLE, ME 04901-5173 United States Phone: 207-660-4549 | Fax:207-660-4529 | ||||||||||||||||
| Secondary Practice Address(es) | 21808 SR 54 | ||||||||||||||||
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